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The Joint Commission disseminates "sentinel event alerts" identifying specific sentinel events, their underlying causes, and steps to prevent recurrence. [5] Further nursing research is ongoing at a number of "magnet" hospitals in the United States, especially to reduce the number of patient falls that may lead to sentinel events.
The US Food and Drug Administration cataloged 566 deaths from ignored alarms in the period 2005 to 2008. [5] The United States-based Joint Commission's sentinel event reports 80 alarm-related deaths and 13 alarm-related serious injuries over the course of a few years.
In addition, the Joint Commission created a "do not use" list of abbreviations [52] in 2004 to avoid acronyms and symbols that lead to misinterpretation. Identifying sentinel events and analyzing the root causes has been a focus of TJC since 1996; the first eight alerts were published in 1998. The Commission defines a sentinel event as "any ...
The Joint Commission is one of the most widely used accreditation organizations. The International Society for the Quality in Healthcare (ISQua) is the umbrella organization responsible for accrediting the Joint Commission accreditation scheme in the US and Accreditation Canada International, as well as accreditation organizations in the United ...
The Joint Commission's Annual Report on Quality and Safety 2007 found that inadequate communication between healthcare providers, or between providers and the patient and family members, was the root cause of over half the serious adverse events in accredited hospitals. [66]
The Joint Commission's Annual Report on Quality and Safety 2007 found that inadequate communication between healthcare providers, or between providers and the patient and family members, was the root cause of over half the serious adverse events in accredited hospitals. [51]
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The aims of RADAR are to disseminate safety reports for serious adverse drug reactions (sADRs) and to identify barriers to identification and reporting of these clinical events. Investigators have developed a well-coordinated system to accurately compile case report information on sADRs and to identify milestones associated with identification ...